CAJ | 학술논문

目的总结6例原发性甲状旁腺功能亢进症(PHPT)的外科诊治经验.方法回顾性分析我院近14年间6例手术治疗的PHPT的临床资料.结果 5例术前全段甲状旁腺激素均高于正常值(2.5～15倍),术前B超检查均诊断甲状旁腺肿瘤.CT检查4例,2例诊断为甲状旁腺肿瘤,1例误诊为甲状腺炎,1例误诊为甲状腺结节.~(99)Tcm-MIBI检查3例,1例诊断为甲状旁腺瘤,2例未发现甲状旁腺肿瘤.术后病理诊断:甲状旁腺腺瘤5例,甲状旁腺增生1例.1例甲状旁腺增生复发.无手术并发症.结论血钙浓度检查具有重要的诊断价值.骨质疏松和多发泌尿系结石者要考虑本病.全段甲状旁腺激素检查有利于确诊,B超和~(99)Tcm-MIBI扫描对制定手术方案有重要意义.大多数PHPT适合行单侧颈部探查术.甲状旁腺增生需探查双侧甲状旁腺,术后可能复发.甲状旁腺癌少见.
목적 총결6례원발성갑상방선공능항진증(PHPT)적외과진치경험.방법 회고성분석아원근14년간6례수술치료적PHPT적림상자료.결과 5례술전전단갑상방선격소균고우정상치(2.5～15배),술전B초검사균진단갑상방선종류.CT검사4례,2례진단위갑상방선종류,1례오진위갑상선염,1례오진위갑상선결절.~(99)Tcm-MIBI검사3례,1례진단위갑상방선류,2례미발현갑상방선종류.술후병리진단:갑상방선선류5례,갑상방선증생1례.1례갑상방선증생복발.무수술병발증.결론 혈개농도검사구유중요적진단개치.골질소송화다발비뇨계결석자요고필본병.전단갑상방선격소검사유리우학진,B초화~(99)Tcm-MIBI소묘대제정수술방안유중요의의.대다수PHPT괄합행단측경부탐사술.갑상방선증생수탐사쌍측갑상방선,술후가능복발.갑상방선암소견.
Objective To discuss the diagnosis and surgical treatment of primary hyperparathyroidism(PHPT).Methods Clinical data of 6 cases of PHPT were retrospectively analyzed in the past 14 years in our hospital.Results Serum PTH level of five Cases was elevated(2.5 to 15 folds).Five cases undergone preoperative ultrasound scan were diagnosed as parathyroid tumor.Of which 4 cases undergone CT scan.2 cases were diagnosed as parathyroid tumor,2 cases were misdiagnosed as thyroiditis.1 case was misdiagnosed as thyroid nodule.3 cases undergone ~(99)Tcm-MIBI Scan,1 case was diagnosed as parathyroid adenoma,parathyroid tumor was not found in two cases.Postoperative pathological diagnosis:five parathyroid adenoma,1 parathyroid hyperplasia.The parathyroid hyperplasia recurred postoperatively.No operative complications were found.Conclusions Blood calcium concentration play an important seaning diagnosis role.Osteoporosis and multiple urinary stones must be considered of this disease.Intact parathyroid hormone examination is helpful for diagnosis.Ultrasound scan and ~(99)Tcm-MIBI scanning program have great significance to make surgery plan.Unilateral neck exploration is appropriate for most cases of PHPT.Parathyroid hyperplasia need bilateral parathyroid exploration,may recur after operation.Parathyroid Cancer is relatively rare.